Gabrielle Pelham, LPC ATR-P

Primary specialty

CounselorTaxonomy code 101Y00000X

License

178.014859 Issued in IL

Practice address

900 E Diehl Rd Ste 110
Naperville, IL 60563-4808

Phone

(630) 428-7890

NPI assigned

Jun 18, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: lifestancehealth.gabriellepelham@146897.advancedmd-direct.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1592438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1871119552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E DIEHL RD STE 110",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605634808",
            "telephone_number": "630-428-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E DIEHL RD STE 110",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605634808",
            "telephone_number": "630-428-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELHAM",
        "first_name": "GABRIELLE",
        "credential": "LPC ATR-P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-18",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "IL",
            "license": "19-564",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178.014859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark A Pedigo, LCSW
• Mark Anthony Pedziwiatr Jr.
• John Peggau, PYSD
• Lisa Peirce Boyle, M.ED., BCBA
• Renee Lori Peksa-Sink, D.O.
• Dalip Pelinkovic, M.D.
• Mark Pelka, M.D.
• Lisa C Pellegrini, M.D.
• Roberto Pena Jr., LCSW, CADC
• Pendle Consulting LLC

• Counselor in Naperville, IL
• Providers in Naperville, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.